Brainstem Evoked Potentials Score and Composite Autonomic Scoring Scale as a Predictors of Disease Progression in Clinically Isolated Syndrome

- Croatian Science Foundation

HRZZ Installation Research Project

Multiple sclerosis (MS) is a chronic idiopathic demyelinating illness of the central nervous system and it is the leading cause of disability in young adults. About 85% of patients have onset of MS with a relapse, which is known as a clinically isolated syndrome (CIS). Several studies have shown that infratentorial lesions are related to conversion rate and long-term prognosis for patients with CIS and thus may help to identify patients at high risk for earlier occurrence of clinically relevant disability. Bearing in mind the poor correlation between clinical symptoms and MRI findings there is a need for ancillary tools in the evaluation of brainstem pathology in MS. The aim of the current study is to evaluate the role of the brainstem evoked potentials score (bilateral AEP, bilateral ocular and cervical VEMP and bilateral tongue SSEP), the modified evoked potentials score (combination of brainstem evoked potentials score and VEP and SSEP of the median and tibial nerve) and standardized autonomic nervous system testing (Composite Autonomic Severity Score (CASS)) in the prediction of conversion from CIS to MS and accumulation of future disability.

It can be presumed that the brainstem EP score and CASS score as direct and indirect measures of brainstem dysfunction will prove as reliable markers of conversion to clinically definite MS and predictors of future disability of CIS patients. As a consequence, this would allow us to start more appropriate (aggressive) treatment in a subset of patients with higher probability of worse outcome.

Team Members

  • Assist. Prof. Mario Habek, PhD, MD (Project leader)
  • Tereza Gabelić, PhD, MD
  • Ivan Adamec, PhD, MD
  • Barbara Barun, PhD, MD
  • Ivana Zadro, PhD, MD
  • Luka Crnošija, MD
  • Magdalena Krbot Skorić, PhD, MS EE
  • Assist. Prof. Darija Mahović Lakušić, PhD, MD
  • Prof. Damir Petravić, PhD, MD
  • Assist. Prof. Branko Malojčić, PhD, MD
  • Prof. Ivo Lušić, PhD, MD
  • Prof. Silva Butković Soldo, PhD, MD
  • Marijana Lisak, PhD, MD
  • Mila Lovrić, PhD


Laboratory & Equipment

Laboratory for the autonomic nervous system testing

Head: Assist. Prof. Mario Habek, PhD, MD

The Task Force® Monitor is the state-of-the-art diagnostic tool allowing to study syncope and autoregulation of blood pressure. The Task Force® Monitor provides all relevant hemodynamic parameters completely synchronized and full hemodynamic assessment.

Q-Sweat System (WR Medical Electornics): The Q-Sweat Quantitative Sweat Measurement Lab provides the efficient evaluation of sweating.

Laboratory for evoked potentials

Head: Tereza Gabelic, PhD, MD

Medelec Synergy EMG/EP® system, Viasys Healthcare, is a 10-channel amplifier system for suitable for VEP, AEP and SEP recordings.

Laboratory for cognitive and experimental neurophysiology

Head: Magdalena Krbot Skoric, PhD, MS EE

BrainAmp DC®, BrainProducts GmbH, Germany, is amplifier that can be used for a variety of neurophysiological applications, ranging from standard EEG/ERP recordings to simultaneous EEG/TMS.

E-Prime®, PsychologySoftware Tools, is software for computerized experiment design, very detailed and precise data collection, and analysis.